Background Osteosarcopenic obesity syndrome (OSO) is a disease that seriously endangers the health of older people. The rational classification of the disease can guide the clinical diagnosis and treatment. Therefore, classifying OSO based on inter-correlations of its diagnostic variables and exploring its structural properties may offer insights into clinical prevention and treatment of OSO. Objective To explore the structural properties of OSO, providing a theoretical basis for individualized diagnosis and treatment of the disease. Methods A cross-sectional study was conducted with a random sample of OSO patients (≥60 years old) who underwent physical examination in Physical Examination Center, the 2nd Affiliated Hospital of Harbin Medical University from January 2018 to December 2020. The data collected include 9 diagnostic variables for OSO〔skeletal muscle index, grip strength, body fat percentage, BMD of the lumbar spine (L1-L4), hip and femoral neck, BMI, waist circumference, walking pace〕, sociodemographic characteristics, lifestyle and prevalence of common chronic diseases. KMO test and Bartlett's test of sphericity were used to evaluate the suitability of diagnostic variables for factor analysis. The components with an eigenvalue equal to or greater than 1.000 were extracted by principal component analysis, and the varimax orthogonal rotation matrix was obtained by the varimax orthogonal rotation method. The common factors were named according to the orthogonal rotation matrix of factors. On the basis of factor analysis, thesum of squares and systematic cluster analysis were used to develop a dendrogram for classifying patients. The structural properties of OSO were analyzed by comparing the values of diagnostic variables and clinical features among patients of different categories. Results A total of 107 cases were included. The KMO value (0.688) and the result of Bartlett's test of sphericity (χ2=492.374, P<0.001) indicated that the data of diagnostic variables were suitable for factor analysis. Three common factors (osteoporosis factor, muscle + body fat factor and obesity factor) with an eigenvalue greater than 1.000 were extracted, explaining 81.408% variance of the total. The load value of each diagnostic variable on its common factor ranged from 0.770 to 0.918. The patients were divided into 3 categoriesby cluster analysis using the common factors. The skeletal muscle index, grip strength, body fat percentage, BMD of L1-L4, hip and femoral neck, BMI and waist circumference varied significantly across patients of different categories (P<0.05). The values of BMD of L1-L4, hip and femoral neck of OSO patients in the first category were significantly lower than those of the other two categories (P<0.05). The BMI and waist circumference values of OSO patients in the second category were lower than those of the other two categories (P<0.05). OSO patients in the third category had higher values of skeletal muscle index, grip strength and BMD of L1-L4, hip and femoral neck, but lower body fat percentage than those of the other two categories (P<0.05). There were statistically significant differences in sex ratio, distribution of education level and total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), uric acidand creatinine in the serum among different categories of patients (P<0.05). OSO patients in the first category had higher prevalence of below the undergraduate education level than those in the third category (P<0.017). OSO patients in the second category had higher level of TC than those in the third category (P<0.05). In comparison with those in other two categories, OSO patients in the third category had higher personal monthly income equal to or greater than 5 000 yuan, and lower female ratio (P<0.017). Moreover, OSO patients in the third category also demonstrated higher levels of uric acid and creatinine in the serum (P<0.05) . Conclusion OSO diagnostic variables can be generalized and interpreted in terms of osteoporosis, muscle and body fat, and obesity. And OSO patients have different structural properties. The application of multivariate statistical methods to study the structural properties of OSO patients will contribute to the individualized management of such patients.

目的 分析国内外现阶段慢性病健康传播文献,从中发现该领域重点主题、热点及空白,为我国探索基于健康传播视角的慢性病防控新策略提供前期的研究基础.方法 选取CNKI和Web of Science作为数据来源,对国内外慢性病健康传播文献通过可视化软件CiteSpace,从年代分布、关键词、研究热点、研究前沿等方面进行对比分析.结果 国内文献发文量远低于国外,以"糖尿病""健康信息""健康素养"等为重要关键词,得出4个聚类.国外以"communication""attitude""internet""women"等为重要关键词,得出8个聚类;"barri-er""literacy""oncolgy"为近期突现热点.结论 我国慢性病健康传播研究虽有所成就,但远落后于国外研究进度、深度,我国应拓宽研究视野,发挥多元主体作用,注重人际传播及其实践研究,填补家庭传播空白,关注信息质量和传播效果.

目的:了解哈尔滨市社区中老年居民焦虑情况,分析焦虑与应激性生活事件的关系.方法:于2017年1—5月对哈尔滨市康安社区和曲线社区≥40岁人群进行横断面研究,调查焦虑及应激性生活事件情况.结果:528名中老年居民中,焦虑情绪检出率为28.6％.女性焦虑情绪的检出率比男性高.单身者焦虑情绪检出率比在婚者高.多因素分析结果显示,应激性生活事件和消极应对高分组相比于低分组,出现焦虑情绪的风险大.结论:社区中老年人焦虑检出率较高,女性及单身者易于出现焦虑,应激性生活事件及消极应对可能是产生焦虑情绪的危险因素.

背景 近年来由高血压导致的死亡率逐年攀升,并呈现一定的性别差异,研究不同性别高血压患者的求医行为对解决这一问题有重要意义.目的 探寻不同性别老年高血压患者求医行为的影响因素,为更有效地控制社区高血压,提高患者生活质量提供理论依据.方法 于2016年5—8月,采用多阶段抽样法选择哈尔滨市南岗区和道里区年龄≥60岁的原发性高血压病患者367例进行问卷调查.调查问卷内容包括一般情况、健康相关认知及求医行为.比较不同性别老年原发性高血压患者求医行为及其他变量的差异,采用多因素Logistic回归分析不同性别老年原发性高血压患者求医行为的影响因素.结果 共回收有效问卷343份(93.5％).183例(84.7％)女性老年高血压患者有求医行为,94例(74.0％)男性老年高血压患者有求医行为,女性老年高血压患者的求医行为发生率高于男性,差异有统计学意义(χ2=5.900,P=0.015).322例(93.9％)老年高血压患者关注健康;>70％ 老年高血压患者对高血压疾病相关认知正确;老年高血压患者对高血压药物相关认知正确率不高.月收入、体检行为、是否关注健康、"血压控制不良引发冠心病""血压高的时候吃药,正常就可以停药"认知是否正确是男性老年原发性高血压病患者求医行为的影响因素(P<0.05).受教育程度、"高血压病不能完全根治"认知是否正确是女性老年原发性高血压病患者求医行为的影响因素(P<0.05).结论 城市老年高血压患者的求医行为形成的敏感因素存在性别差异,应对不同性别的干预敏感靶点开展更有针对性的高血压求医行为的干预措施.

目的 探讨父母教养方式、家庭功能与人格在中学生焦虑症状间的路径关系.方法 采用多阶段抽样方法,运用父母教养方式评价量表(EMBU)、艾森克个性问卷(EPQ)、症状自评量表(SCL-90)和家庭功能问卷(APGAR)对哈尔滨市某区984名中学生进行了统一问卷调查.结果 ①焦虑症状与F2～F3、F5～F6、M2～M4呈显著正相关(r=0.29～0.40);与F1、M1及家庭功能五个维度呈显著负相关,相关程度r=-0.31～-0.09;②N、F5、F6解释男生焦虑症状程度的37.4％,Pa、F5、M2解释男生神经质的15.9％;N、Af、M3、M1解释女生焦虑症状的44.0％,Re、Af、F6、M3解释女生神经质变异程度的22.5％;③中介效应和路径分析:Pa和M2通过N对男生焦虑症状呈完全中介作用,F5既通过N间接影响又直接影响男生焦虑症状,F6则对男生焦虑只有直接影响作用,模型对男生焦虑症状的总解释度为35％;N在Af、M3与女生焦虑问题中起部分中介作用,Re、F6呈完全中介,M1则只有直接作用,女生焦虑模型的解释度为44％;④追踪数据:男女生焦虑模型稳定性好,且男生模型的测定系数提升至40％.结论 父母教养方式和家庭功能通过神经质人格对男女生焦虑症状的路径机制存在,为家庭心理干预提供了科学方向.

Objective To investigate the current status of professional identity among the undergraduates majoring in public affairs management and the related influence factors.Methods A stratified cluster sampling method was used to conduct a questionnaire survey among the 115 undergraduates majoring in public affairs management in a medical university in Harbin,China,and the contents of the questionnaires included general status and professional identity.The t-test,one-way analysis of variance,and multiple linear regression analysis were used to analyze the influencing factors of professional identity.In-depth interviews were conducted for some students to explore the profound influencing factors for professional identity among the students majoring in public affairs management.Results The overall level of professional identity was low among the undergraduates majoring in public affairs management in the medical university in Harbin,and the score of professional identity was 3.25 ± 0.56.The scores of cognitive dimension,emotional dimension,behavioral dimension,and applicable dimension were 3.41 ± 0.69,3.21 ± 0.78,3.24 ± 0.71,and 3.13 ± 0.72,respectively.The multivariate analysis showed that grade,academic performance,major selection,and children number in family had significant influence on their professional identity.The students who were at grade four,who had high academic record (b =-0.276,P＜ 0.01),who chose this major independently (b=-0.277,P＜0.01),and who were the only child (b=-0.233,P＜ 0.05) had a high score of professional identity.As for the undergraduates at different grades,the undergraduates at grades two and three had a significantly lower score of professional identity than those at grade four (b=-0.296 and-0.369,P＜0.05),while there was no significant difference between the undergraduates at grades one and four (b=-0.008,P＞0.05).Furthermore,the students with a high score of professional identity had higher possibility to pursue the job related to this major than those with a low score (3.39 ± 0.53 vs.2.92 ± 0.49,t=4.414,P＜0.01).Conclusion Universities should strengthen the publicity of the major of public affairs management,optimize the curriculum,and add job experience,so as to enhance professional identity among students with this major and provide talent for the field of public health management.

目的 探讨中学生不良行为与人格和父母教养方式间的直接与间接路径,为预防中学生不良行为,完善干预路径,降低不良行为发生率提供依据.方法 采用艾森克个性问卷(EPQ)、父母教养方式评价量表(EMBU)、自编不良行为问卷对789名中学生进行统一问卷调查.结果 中学生不良行为的检出率为34.85％,其中高中(38.75％)显著高于初中(30.17％)(x2=6.34,P=0.01);存在行为问题的学生神经质和精神质得分显著低于正常组(tN=-13.44,P＜0.01;t,=-6.48,P＜0.01);父亲情感温暖理解、惩罚严厉、母亲过分干涉过度保护与神经质、精神质对不良行为的解释度为26.1％,中介效应值占比分别为26.37％、18.18％和43.37％,神经质人格在父亲拒绝否认、过度保护和不良行为间起完全中介作用.结论 父母教养方式不仅对不良行为发生有直接预测,还通过人格特征间接预测不良行为的发生.

目的 了解掌握黑龙江省境外务工人员健康素养现况及影响因素,为提高其健康素养并制定此领域健康规划提供科学依据.方法 对2017年1-10月黑龙江各口岸出国务工人员共216人进行健康素养问卷调查,将调查结果进行统计学分析.结果 调查对象中男性153人(占70.8％),女性63人(29.2％);平均年龄在39.40±9.30岁;初中以下文化126人(占58.4％),在婚158人(占73.1％).参与本次调查的出国务工人员中,女性的健康素养显著高于男性;文化程度越高其健康素养水平越高;年收入水平越高的群体健康素养水平越高;出国从事商业/服务员、技术人员、个体工商户类型职业的人群健康素养水平高于其他职业的出国务工人群;未患慢性病的出国务工人员的健康素养显著高于慢性病患者.结论 应加强对境外务工人员健康素养教育,提高全民健康素养,实现“健康共治”.

Objective To investigate the mediating effects of neurotic personality between parental rearing patterns and depressive symptom.Methods Using multistage sampling method,982 town middle-school students were surveyed by the Symptom Checklist 90(SCL-90),the Egna Minnen av Barndoms Uppfostran (EMBU),the Eysenck Personality Questionnaire (EPQ).Correlation and regression analysis,mediating effect test,and structural equation model were constructed.Results ①)Depressive symptom (D) (1.73 ± 0.72) was significantly associated with Neurotic personality (N) (51.50± 11.37) and parental rearing patterns (r=-0.138-0.582,P＜0.01).②N,mother's rejection and deny(M3),father's emotional warmth and understanding(F1),father's over-protection(F6) had a direct effect on D,which can explain 41.6％ of the variance.F1,F6,mother's over-interference and over-protection(M2),M3 had a direct effect on N,which can explain 15.3％ of the variance.The mediating effect of N between F1,F6,M2 and D were significant(95％CI =-0.212--0.069,-0.351--0.233,0.414-0.480).③The explanation for D was 41.3％.N had completely mediating effect between M2 and depressive symptom.N had partial mediating effect between F1,F6 and D,and the proportion was 43.6％ and 49.1％.Conclusion Neurotic personality plays a mediating role between parental rearing patterns and depressive symptom in middle-school students.

目的 了解哈尔滨市社区老年女性的慢性病患病状况,探寻慢性病患病状态对老年女性生活质量的影响.方法 采用整群抽样的方法,利用SF-36量表测量研究对象的生活质量,并进行血液检查等了解慢性病现况.结果 研究对象共303人,有效率为97.7％.慢性病中血脂异常患病率最高(73.6％),其次高血压(63.7％)、糖尿病(14.9％).高血压对研究对象的生活质量的总分以及3个维度有负性影响,包括生理机能、一般健康状况、精力(P＜0.05).没有发现其他两种慢性病对研究对象的生活质量产生明显影响.结论 哈尔滨市社区老年女性慢性病患病情况较重,并影响其生活质量,需要加强相应的健康教育及健康管理工作.

Objective To explore the effect of health education curriculum reform with "social practice" as the core on impact on students knowledge of smoking control and social responsibility, and to provide theory and guidance for the implementation of health education teaching reform of smoking control in medical colleges. Methods Health education curriculum reform intervention centered on ""social practice of tobacco control" was carried out among clinical and public health students who entered professional courses. A unified questionnaire survey was conducted on "basic knowledge of tobacco control" and "sense of social responsibility" of 216 students before class and 207 students after class to evaluate the intervention effect. Results The passing rate before and after intervention was 7.6％ and 16.4％ (χ2=7.67, P＜0.01). The highest recognition rate after intervention was 17.1％ (P＜0.01) and the highest social responsibility for tobacco control was 21.2％ (P＜0.01). Conclusion The curriculum reform with social practice as the core is effective in improving the awareness rate of basic knowledge of tobacco control and the recognition rate of social responsibility.

目的 探讨城镇中学生各种精神心理症状/问题随年龄增长的变化特点与稳定性,为学校制定有针对性的心理健康教育计划提供科学依据.方法 运用症状自评量表(SCL-90),在自然升学的教育条件下对251名初一、高一学生进行了18个月的追踪观察,采用差均值、相关分析及率、吻合度分析.结果 ①差均值、相关分析(r):初中男生、高中女生SCL-90各症状分18个月后差均值均有升高;初中男生18个月前后相关系数均在0.33以下,只有人际敏感和偏执有统计学意义(P＜0.05);高中女生相关系数最低为0.41,最高为0.78(P ＜0.01).②率、吻合度分析(κ系数):前后精神心理问题率的比较无差别;高中生总问题率比初中生前后吻合度高,且男生(0.60)高于女生(0.42);进一步分析,高、初中女生前后睡眠饮食问题吻合度最高,分别为0.85和0.79,其次是高中男生为0.66(P ＜0.01).结论 随年龄增长,初中生各种精神症状和问题稳定性差,高中生较强,提示初中阶段是实施学校心理健康教育与干预的最佳时期.

Objective To analyze the treatment behavior of old hypertension patients,and offer suggestions of improving hospital community integration management to increase the treatment rate of hypertension.Methods The old hypertension patients in Harbin were selected as research subject.The inquiry questionnaires were used to investigate,and x2 test,one-and multi-factor logistic regression were used to analyze the influence factors of treatment behavior.Results Exception of Body Mass Index,physical factors,socioeconomic status and physical examination do not influence the treatment behavior of hypertension patients.The hypertension patients who keep correct cognition on hypertension and medicine are inclined to treat hypertension.The more subjects agree with the susceptibility to complications of hypertension and the severity of hypertension complications,the more they treat hypertension.But the attentions to health do not affect treatment of hypertension significantly.Conclusion It is very important to strengthen hospital community integration management to increase treatment rate of old hypertension patients,and finding the effective "target point" is the key.

目的:了解新媒体对大众防烟/控烟(以下简称控烟)的正面影响,强化新媒体在控烟知识传播中的作用,为制订有效的新媒体干预策略提供科学依据.方法:运用网上与面对面的方便抽样调查方法,对664名大众进行自编调查问卷统一调查.结果:有26.5％的受访者认为新媒体对其的控烟意识产生了正面影响,正面影响在年龄(x 2 =10.03,P=0.04)、吸烟情况(x 2=7.17,P=0.007)、控烟知识关注程度(男性x2=29.03,P=0.000;女性x(2=32.83,P=0.000)上存在显著差异,此外新媒体对女性医护教师的正面影响大(P＜0.01),不同类型媒体对女性控姻意识产生的影响差异显著(P＜0.05).结论:新媒体对大众控烟态度的正面影响作用逐渐显露,并受年龄、吸烟情况和控烟知识关注度等的影响,与性另和受教育程度无明显关系,应有针对地加强其正面影响力度,减少或消除烟草公司利用新媒体阻碍我国控烟履约进程的一切行动.

Objective To explore the distribution and characteristics of health risk behaviors between the male and female college freshmen in the medicine and science,and to provide evidence for appropriate health intervention measures.Methods A questionnaire investigation was performed on college students'health risk behaviors among 1019 freshmen from medical and science college in urban area of Harbin.Results (1)There were statistically significant among the different gender in difference of risky behaviors except playing video games,net surfing,considered suicide,drug abuse and a few activities outside the 60 minutes every day (P ＜ 0.01 ).(2)Medical male risk behavior of the frequency(56.4％,19.2％,12.7％ and 47.1％ )higher than that of science and engineering male(35.6％,5.2％,1.6％ and 17.3％ )in trying to smoking,current smoking,sexual behavior and breakfast skipping.Recent medical males drinking rate was 85.3％ higher than male of science and engineering 72.2％.The incidence of female science and engineering students,respectively( 89.3％,50.8％ and 38.5％ ) than female medical students (72.4％,36.9％ and 8.0％ ) in trying to drinking and recent drinking and breakfast skipping.Conclusion The risk behaviors of college freshmen were prevalent.The frequency of risk behaviors are different among the College Freshmen in different genders and with different major,respectively.Therefore,it is necessary to take measures for intervention.

Objective To explore the tobacco control project based health education curriculum reform's effect of improving medical students' tobacco control.Method Choosing the students of two classes of students in preventive medicine specialty of Harbin Medical University as the research object, investigating the students respectively with the questionnaire prepared uniformly by 7 schools before and after the course.All data were coded by Epidata 3.0, and SPSS 18.0 was used to carry out the relevant information for the chi square test and t test.Result The sample size of baseline survey was114 and after the intervention was 87.The knowledge pass rate of the girls before and after the intervention were 87.3％ (48/55) and 98.2％ (54/55) respectively (P=0.000).The boys' awareness rate of the secondhand smoke safety level were 13.6％ (8/59) and 21.9％ (7/32) respectively, and the girls were 13.0％ (7/55) and 31.5％ (17/55) (P=0.021).Students interested in tobacco increased from 79.8％ (91/114) before intervention to 90.8％ (79/87) after intervention (P=0.033).Students willing to work in the tobacco related increased from 52.2％(59/114) before intervention to 66.7％ (58/87)after intervention (P=0.044).The girl who replied after intervention "I am not smoking now, but won't smoke either when working in the disease control in the future" reached as high as 96.4％ (53/55), but the students were lack of confidence to help people to stop smoking.Conclusion The reform of social practice activity curriculum designed for tobacco control project is effective, and it is urgent to strengthen the training of preventive medical students' smoking cessation skills and enhance their confidence.

The reform of foreign students education has become an important topic along with the increase of international academic communication and the development of foreign students education.This article introduces teaching experience about the application of learner-centered teaching mode in nutrition for foreign students, including the reforms in the teaching outline, teaching tools,teaching methods,class organization and examination in order to provide some suggestions for the reform in other universities.

Objective To compare the impact of tobacco control curriculum on self-efficacy of tobacco control in different major of public health students, and offer theoretical foundation for improving tobacco control curriculum.Methods We offered tobacco control curriculum for 150 public health students (including students of preventive medicine and public service administration research direction) in medical university of Harbin, and investigated twice general self-efficacy, smoking selfefficacy and tobacco control self-efficacy before and after tobacco control curriculum, then compared intervention effects between two major students by t test.Results There were no differences of tobacco control self-efficacy, smoking self-efficacy and general self-efficacy between two major students, t values were-0.832 (P=0.407), 0.190 (P=0.849) and-0.492 (P=0.624).The tobacco control self-efficacy (t=-3.566, P=0.001) and general self-efficacy (t=-2.237, P=0.028) increased remarkably but smoking self-efficacy (t=-1.102, P=0.273) in preventive medicine students after intervention.And all of three kinds of self-efficacy were not gotten better by intervention in public service administration students.There was no obvious difference of intervention effects between tobacco control self-efficacy and general self-efficacy among preventive medicine students (t=1.541, P=0.125).Conclusions The improvement of preventive medicine students by tobacco control curriculum is better than that of public service administration students.We should further perfect the tobacco control course, and on the one hand, improve the intervention effect of students majoring in course of public health management;on the other hand, strengthen the target effects of the tobacco control curriculum to students' tobacco control self-efficacy and smoking self-efficacy.

采用问卷方式调查241名高等医学院校教师对隐性课程认知与认同状况.结果表明教师对隐性课程的认知程度较低,有76.35％的教师从未听说过隐性课程.男性教师对隐性课程的认知度高于女性;年龄越大、职称越高的教师对隐性课程的认知度越高.93.78％的教师愿意了解并在教学中运用隐性课程.因此,提高高等医学院校对隐性课程的认识与认知势在必行.

[目的]了解医科院校教职工对控烟职业责任感的认同情况及控烟教育能力. [方法]采用分层按比例的抽样方法,对某医科大学学校本部8个部门和4所附属医院的教职工控烟责任感和教育能力进行问卷调查. [结果]发放问卷796份,回收796份,有效问卷为745份.吸烟者中经常在同事面前吸烟的占60.2％;不吸烟女性介意他人在自己附近吸烟者占95.0％;60.4％吸烟者不支持单位应该有室内全面禁烟的规定;80％以上的教职工认同不在病人、学生和同事面前吸烟、做不吸烟的榜样;过去一年里教师在课堂内容中讲解烟草危害和拒绝烟草、提供戒烟帮助的占20％～50％,不劝别人戒烟的主要原因是没有掌握控烟技术. [结论]教职工控烟态度积极,但行动不足,急需提高医科院校教职工控烟职业责任感和专业防烟和控烟技能.